Provider Demographics
NPI:1932591831
Name:DRS. SEHY AND JONES OPTOMETRISTS P.C.
Entity type:Organization
Organization Name:DRS. SEHY AND JONES OPTOMETRISTS P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:217-342-2672
Mailing Address - Street 1:303 N KELLER DR
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-1859
Mailing Address - Country:US
Mailing Address - Phone:217-342-2672
Mailing Address - Fax:
Practice Address - Street 1:104 OAK ST
Practice Address - Street 2:SUITE A
Practice Address - City:PANA
Practice Address - State:IL
Practice Address - Zip Code:62557-1580
Practice Address - Country:US
Practice Address - Phone:217-562-2672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRS. SEH1303Y AND JONES OPTOMETRISTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060001914152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT35927Medicare UPIN
IL0520540001Medicare NSC